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Partnering with Chinese Immigrant Religious Institutions to Raise HIV Awareness and Confront Stigma. HIV Quality Improvement Learning Network New York City Health and Hospitals Corporation Monthly Topical Conference Call October 9, 2013 John J. Chin, Ph.D.
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Partnering with Chinese Immigrant Religious Institutions to Raise HIV Awareness and Confront Stigma HIV Quality Improvement Learning Network New York City Health and Hospitals Corporation Monthly Topical Conference Call October 9, 2013 John J. Chin, Ph.D. Associate Professor, Department of Urban Affairs and Planning Hunter College, City University of New York john.chin@hunter.cuny.edu
Public Policy Contexts • White House Office of Faith-based and Neighborhood Partnerships • Nonprofit Law: • Not required to apply for tax-exempt status • Not required to file IRS 990 Form • Religious Land Use and Institutionalized Persons Act (RLUIPA) • Increasing presence of evangelical grassroots movements in politics • Religion’s impact on HIV/AIDS policy
Background: Asian American Population and HIV/AIDS Epidemiology
Asian Population • Asian population growth in NYC • 71% between 1990 and 2000 • 32% between 2000 and 2010. • More than one million Asians in NYC in 2010 (about 13% of NYC’s total population).
Asian Population • 45% of Asians in NYC are Chinese. • 72% of the Asian population in NYC is foreign-born. http://www.aafny.org/cic/briefs/nycbrief2006.pdf
Asians and HIV in the US Chin JJ, Leung M, Sheth L, Rodriguez TR. Let's Not Ignore a Growing HIV Problem for Asians and Pacific Islanders in the U.S. (2007). Journal of Urban Health. 84(5):642-7. HIV/AIDS prevalence relatively low, but signs of rapid increase. Between 2001 and 2004, Asians had the only statistically significant increases in HIV/AIDS diagnosis rates in the US. In the same period, NYCDOH reported that in NYC “the number of new HIV diagnoses each year has declined in all racial/ethnic groups except Asian/Pacific Islander.”
HIV/AIDS in the Asia • AIDS has reached epidemic proportions in parts of Asia, home to 60% of the world’s population. • Approximately 4.7 million people living with HIV in 2008 • New annual HIV infections decreased: • 400,000 in 2001 • 350,000 in 2008
Guiding Questions • Are religious institutions good partners in promoting HIV awareness and reducing stigma? • Can they support the best scientifically supported approaches to HIV prevention?
New York City New Reported HIV Diagnoses: Race by Year
New York City, API • There were 1,936 APIs “known” to be living with HIV/AIDS in NYC, at end of 2011, compared to 803 at the end of 2001, an increase of 141% over the 10-year period.
Background: HIV Stigma in Asian American Communities
Stigma and Isolation High level of perceived stigma. Perception that Asians are more un-accepting than other groups. Some cases show that it is possible to tell friends and family and get support. Other experiences are very negative.
Mental health Because of isolation, many respondents spoke of being sad, lonely or anxious. 71% of APIs had low or very low mental health scores, compared to 50% for other New Yorkers with HIV.
APICHA – Asian and Pacific Islander Coalition on HIV/AIDS (NYC)
Image/Reputation Concerns I: How do you think other people in your temple would feel about the temple being involved in activities with an AIDS focus? Who would approve or who would oppose? …. R: …we would be absolutely supportive and cooperative… I: How about other people in the community, Chinatown, do you feel your temple’s involvement in an AIDS-related educational or supportive program in the future would change their perception of this temple? R: I haven’t thought about it, but I don’t think so. Because we…If we were to use our own name, then it may not be okay, but as long as we participate in activities done by outsiders, then it should be no problem.”
Fear of Difference • “we’re not ready to have these different social groups come, lower class, or troubles or issues the church will not be ready for. I guess, [our church members] don’t know how to maybe care for them, and in a way, it could be problematic to have their kids mix with our kids, so there is a lot, some fears already, about influence and culture already.”
Homosexuality • “just like any other thing that God sees as sin, …thou should not murder, thou should not steal, thou should not lie, the Bible is very strict … that you should have no immoral relationship …with men and men, women and women.” • “Of course we say homosexuality is not favored by God…In the Book of Romans, it’s said that the things between the same gender are shameful things, God does not like them, and they would get the justified retribution.”
Homosexuality • “Some people will say men being with men, women being with women, then it will cause chaos. I don’t believe that will cause chaos…I don’t think it’s wrong, since it’s only the very few.” • “I know what the Bible says and what the church teaches. But I have an uncle who is gay and I love him. I just wish the church would build bridges instead of burning them.”
The Stigma Challenge • What can we do to eliminate stigma as a factor in increasing HIV risk, creating barriers to care, and contributing to poor mental health and isolation among people living with HIV/AIDS? • How can we motivate our communities’ leaders to speak out against HIV stigma? • Should public policy encourage religious institutions’ involvement in HIV/AIDS education?
